Lesson 4:

Learning Outcomes

When you have finished studying this lesson, you will be able to:

1. Identify the bones of the pectoral (shoulder) girdle, their

functions, and their principal markings.

2. Identify the bones of the upper limb and their principal markings.

3. Identify the bones of the pelvic girdle and their principal

markings.

4. Distinguish between the false and true pelves.

5. Explain why the false and true pelves are important clinically.

6. Compare the principal differences between female and male

pelves.

7. Identify the bones of the lower limb and their principal markings.

The two (2) main divisions of the skeletal system are the axial

skeleton and the appendicular skeleton. As you learned in that

Lesson 3, the general function of the axial skeleton is the protection

of internal organs; the primary function of the appendicular

skeleton, the focus of this chapter, is movement. The appendicular

skeleton includes the bones that make up the upper and lower limbs

as well as the bones of the two girdles that attach the limbs to the

axial skeleton. The bones of the appendicular skeleton are

connected with one another and with skeletal muscles, permitting

you to do things such as walk, write, use a computer, dance, swim,

and play a musical instrument.

contribute to homeostasis by providing attachment points and
leverage for muscles, which aids body movements;

by providing support and protection of internal organs, such as

the reproductive organs; and

by storing and releasing calcium

The primary function is movement

It includes bones of the upper and lower limbs

Girdles attach the limbs to the axial skeleton

The pectoral girdle consists of two bones, the
scapula and the clavicle

The free part has 30 bones (upper limb)

• 1 humerus (arm)
• 1 ulna (forearm)
• 1 radius (forearm)
• 8 carpals (wrist)
• 19 metacarpal and phalanges (hand)
 The medial end The lateral end
articulates with the articulates with the
The clavicle is “S”
manubrium of the acromion forming the
shaped
sternum forming the acromioclavicular
sternoclavicular joint joint

The clavicle is The clavicle is

convex in shape concave anteriorly on
anteriorly near the its lateral edge near
sternal junction the acromion

Clinical Connection - Fractured Clavicle

◼ A fall on an outstretched arm (F.O.O.S.H.) injury can lead to a fractured clavicle

◼ The clavicle is weakest at the junction of the two curves
◼ Forces are generated through the upper limb to the trunk during a fall
◼ Therefore, most breaks occur approximately in the middle of the clavicle
Also called the shoulder blade

Triangular in shape

Most notable features include the spine, acromion, coracoid process and
the glenoid cavity

Spine

•a large process on the posterior of the scapula that ends laterally as the acromion

Acromion

•the flattened lateral portion of the spine of the scapula

Coracoid process

• a protruding projection on the anterior surface just inferior to the lateral aspect of the clavicle

Glenoid cavity

• shallow concavity that articulates with the head of the humerus

The medial (vertebral) border
•closest to the vertebral spine

Lateral border
•closest to the arm

Superior border
• superior edge

Inferior angle
• where medial and lateral borders meet inferiorly

Superior angle
• uppermost aspect of scapula where medial border meets superior border

Subscapular fossa
• anterior concavity where the subscapularis muscle attaches

Supraspinous fossa
• posterior concavity superior to the scapular spine, attachment site for supraspinatus muscle

Infraspinous fossa
• posterior concavity inferior to the scapular spine, site of infraspinatus muscle
Longest and largest bone of the free part of the upper limb

The proximal ball-shaped end articulates with the glenoid cavity of the
scapula

The distal end articulates at the elbow with the radius and ulna

The head of the humerus has two unequal-sized projections

The greater tubercle lies more laterally

The lesser tubercle lies more anteriorly

Between the tubercles lies the intertubercular groove or sulcus (bicipital

groove) where the long head of the biceps brachii tendon is located
Just distal to the head is the anatomical neck

The surgical neck is where the tubular shaft begins and is a common area of fracture

About mid-shaft on the lateral aspect is a roughened area, the deltoid tuberosity where the deltoid tendon
attaches

Capitulum

•a round knob-like process on the lateral distal humerus

Trochlea

•medial to the capitulum, is a spool-shaped projection on the distal humerus

Coronoid fossa

•anterior depression that receives the coronoid process of the ulna during forearm flexion

Olecranon fossa

•posterior depression that receives the olecranon of the ulna during forearm extension

The medial and lateral epicondyles are bony projections to which the forearm muscles attach
 Olecranon - the large,
The longer of the two Located medial to the prominent proximal
forearm bones radius end, the “tip of your
elbow”

Trochlear notch - the Styloid process - the

Coronoid process - the deep fossa that receives thin cylindrical
anterior “lip” of the the trochlea of the projection on the
proximal ulna humerus during elbow posterior side of the
flexion ulna’s head
Right humerus in relation to scapula, ulna, and radius
 The head articulates
Lies lateral to the The head (disc- with the capitulum of
ulna (thumb side of shaped) and neck are the humerus and the
the forearm) at the proximal end radial notch of the
ulna

Radial tuberosity -
Styloid process -
medial and inferior
large distal
to neck, attachment
projection on lateral
site for biceps brachii
side of radius
muscle

The shaft of these There is a proximal

bones are connected radioulnar joint and
by an interosseus a distal radioulnar
membrane joint

Proximally, the head

Distally, the head of
of the radius
the ulna articulates
articulates with the
with the ulnar notch
radial notch of the
of the radius
ulna
Right ulna and radius in relation to the humerus and carpals
 Proximal row -
The carpus (wrist)
Two rows of carpal scaphoid, lunate,
consists of 8 small
bones triquetrum,
bones (carpals)
pisiform

Distal row - Carpal tunnel -

Scaphoid - most
trapezium, space between
commonly
trapezoid, carpal bones and
fractured
capitate, hamate flexor retinaculum

Five metacarpals - numbered I-V, lateral to medial

14 phalanges - two in the thumb (pollex) and three in

each of the other fingers

Each phalanx has a base, shaft, and head

Joints - carpometacarpal, metacarpophalangeal,

interphalangeal
Two separate regions

1. A single pelvic girdle (2 bones)

2. The free part (30 bones)

Each coxal (hip) bone consists of three bones that fuse
together: ilium, pubis, and ischium

The two coxal bones are joined anteriorly by the pubic

symphysis (fibrocartilage)

Joined posteriorly by the sacrum forming the sacroiliac

joints
 Consists of a superior
ala and inferior body
Largest of the three hip Ilium is the superior which forms the
bones part of the hip bone acetabulum (the socket
for the head of the
femur)

Hip pointer - occurs at Greater sciatic notch -

Superior border - iliac
anterior superior iliac allows passage of
crest
spine sciatic nerve

Most prominent feature

Ischium - inferior and is the ischial tuberosity,
posterior part of the hip it is the part that meets
bone the chair when you are
sitting

Pubis - inferior and

Superior and inferior
anterior part of the hip
rami and body
bone
Pelvic brim

• a line from the sacral promontory to the upper part of the pubic symphysis

False pelvis

• lies above this line (Fig 8.9b)

Contains no pelvic organs except urinary bladder (when full) and uterus during pregnancy

True pelvis

• the bony pelvis inferior to the pelvic brim, has an inlet, an outlet and a cavity

Pelvic axis

•path of baby during birth

Comparing Male and Female Pelves
Femur
• Femur - longest, heaviest, and

strongest bone in the body

• Proximally, the head articulates with

the acetabulum of the hip bone forming

the hip (coxal) joint

• Neck - distal to head, common site of

fracture

• Distally, the medial and lateral

condyles articulate with the condyles

of the tibia forming the knee joint

• Also articulates with patella

• Greater and lesser trochanters are

projections where large muscles attach

• Gluteal tuberosity and linea aspera -

attachment sites for the large hip

muscles

• Intercondylar fossa - depression

between the condyles

• Medial and lateral epicondyles -

muscle site attachments for the knee

muscles
Patella
Largest sesamoid bone in the body

Forms the patellofemoral joint

Superior surface is the base

Inferior, narrower surface is the apex

Thick articular cartilage lines the posterior surface

Increases the leverage of the quadriceps femoris muscle

Patellofemoral stress syndrome - “runner’s knee”

Tibia
The lateral and
The larger, medial medial condyles at It articulates distally
weight-bearing bone the proximal end with the talus and
of the leg articulate with the fibula
femur

Medial malleolus -
Tibial tuberosity -
medial surface of
attachment site for
distal end (medial
the patellar
surface of ankle
ligament
joint)
Fibula
The smaller, laterally
placed bone of the Non-weight bearing
leg

Lateral malleolus -
The head forms the distal end,
proximal tibiofibular articulates with the
joint tibia and the talus at
the ankle
Seven tarsal bones - talus (articulates with tibia and fibula),
calcaneus (the heel bone, the largest and strongest),
navicular, cuboid and three cuneiforms

Five metatarsals - (I-V) base, shaft, head

14 phalanges (big toe is the hallux)

Tarsus = ankle
Arches of the Foot
Two arches
Provide spring and The arches flex
support the
leverage to the when body weight
weight of the
foot when walking applied
body

Clawfoot - too
Flatfoot - the
much arch occurs
arches decrease
due to various
or “fall”
pathologies
Read the following instructions carefully before answering:

• Answer the following questions briefly. The maximum number of sentences is 15 only.
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Last Name_First Name_Module_Number
Example: PRE_ELENA_Module 3 Activity

1. Identify the bones of the pectoral (shoulder) girdle, their functions, and

their principal markings.

2. Identify the bones of the upper limb and their principal markings.
3. Identify the bones of the pelvic girdle and their principal markings.
4. Using a table, compare and contrast the false and true pelves.
5. Explain why the false and true pelves are important clinically.
6. Compare the principal differences between female and male pelves.
7. Identify the bones of the lower limb and their principal markings.
CONCLUSION

Now that you have read through this chapter and undertaken the activities, you should

have a good understanding of how the skeletal and muscular systems operate. You should be

able to see how bones and muscles work together to facilitate movement, provide protection

and maintain homeostasis through the regulation of minerals.

Key points

• Bone is a highly vascular connective tissue that has a number of key functions,
namely: support. movement, storage, protection and production of blood cells.

• Bone is composed of extracellular bone matrix and four types of bone cells:
osteogenic cells, osteoblasts, osteocytes and osteoclasts.

• There are two types of bone: spongy and compact.

• Bone formation takes place during embryonic/fetal development through two

processes: intramembranous and endochondral ossification. Bone continues to
grow in length until early adulthood and in width throughout the entire lifespan.

• Bone is continually renewing itself through the process of remodeling and can
repair itself if itis broken.

• There are five (5) classifications of bones based on their shape: long, short, flat,
irregular and sesamoid (the sixth, sutural, is not based on shape).

• There are 206 bones in the adult skeleton. The skeleton is divided into the axial
skeleton consisting of the bones of the skull, the spinal column, the ribs and
sternum, and the appendicular skeleton consisting of the pectoral and pelvic
girdles, bones of the upper extremities and bones of the lower extremities.